• Article
  • June 20, 2017

Humpty Dumpty Program Helping To Prevent Patient Falls

Nicklaus Children's Hospital's patient safety program has spread to help children and hospitals worldwide.

When Jackie Gonzalez and her colleague Debbie Hill-Rodriguez set out to implement a fall safety program at Nicklaus Children's Hospital in Miami, they found the only available tools and protocols designed to prevent patient falls were geared toward the adult population, and they weren't applicable to the distinctive needs of children.

So, along with a team of about a dozen nurses from the hospital, Gonzalez, M.S.N., ARNP, FAAN, senior vice president of patient care and chief nursing officer, and Hill-Rodriguez, M.S.N., RN, PCNS-BC, analyzed data from more than 300 fall events.

Using that information, the team developed a fall risk-assessment scale based on seven grading criteria, including the patient's age, gender and medication usage. The Humpty Dumpty Falls Prevention Program includes different fall-prevention protocols based on the patient's risk score, with higher-risk patients specifically identified to ensure all members of their care team are aware of the heightened risk.

Today, the program has spread to more than 1,300 hospitals globally in 15 different languages, and it has created a much different landscape than a decade ago. "It has spread through word of mouth," Gonzalez says. "This program has grown organically, and it’s wonderful to be a part of it."

Family involvement is key

While analyzing the fall event data, the team made an interesting discovery: parents were present more than 80 percent of the time with hospitalized patients when a fall occurred. As a result, parent and patient education became a priority in the development of the program. The Humpty Dumpty program includes an interactive educational module, which has been well-received by patient families.

"The approach we take is that this is a partnership," says Gonzalez. "It's not, 'We are taking care of your child.' It's, 'We're partnering with you for your child's safety.' That's a powerful message."

Proof of results

Following full implementation of the Humpty Dumpty program, Nicklaus Children's experienced a sustained decline in fall rates from 1.03 per 1,000 patient days in 2009 to 0.42 per 1,000 patient days in 2015—a 41 percent decline. Feedback from participating hospitals around the globe tells a similar story of success.

Pride of a "parent"

For the team at Nicklaus Children's, the impact the Humpty Dumpty program has had on children worldwide is an enormous source of pride. In fact, Hill-Rodriguez, Humpty Dumpty program lead, thinks of this program as her "baby."

"I put it into perspective in terms of my own life," says Hill-Rodriguez. "It's like having a child growing up, going to college, being successful and having a good future. Being a parent whose child went to college last year, I feel the same things with him as I have with Humpty Dumpty over the years."

Send questions or comments to magazine@childrenshospitals.org.